中国新生儿危重病例评分法的应用及展望

Application and prospect of neonatal critical illness score in China

新生儿危重病例评分法(NCIS)从2001年发布至今已有二十余年,在危重新生儿转运、疾病危重程度和预后评估等方面发挥了积极的作用。但随着医疗技术不断发展,该评分系统也暴露出一些局限性,如:未能纳入重要围产信息、单项指标无法定量、未吸氧的PaO2难于获取、评估指标较为复杂、评估耗时较长和数据较难用于科研和总结等,因此有必要对其进行更新和简化以更好适用于危重新生儿的临床救治及科研工作。本文总结了NCIS在中国的使用情况,并与国外一些新生儿常用的危重评分如新生儿急性生理评分、婴儿临床危重指数等进行对比,结合近年来兴起的人工智能与深度学习等技术,为升级NCIS提供理论依据,旨在使其更加简单与优化,增强准确性和适用性,为危重新生儿救治及科研总结发挥更积极的作用。

Neonatal critical illness score(NCIS)has been published for over 20 years in China and has played an active role in critical neonatal transport,illness severity assessment,and prognosis evaluation.However,there are still some limitations in the scoring system with the development of medical technology,such as failure to include crucial perinatal information,unable to quantify single indicators,difficulty in obtaining PaO2 without oxygen inhalation,complex evaluation indicators,long evaluation time and data was difficult for scientific research,etc.Therefore,it is necessary to update and simplify it for the clinical treatment and scientific study of critically ill newborns.This review summarized NCIS application in China and compared it with foreign neonatal critical scores such as score for neonatal acute physiology,clinical risk index for babies,etc.Combined with the rising technology of artificial intelligence and deep learning in recent years,it was more straightforward and optimized to enhance its accuracy and applicability,which was aimed to play a more active role in the treatment of critical newborns and scientific research.